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Puncture Wounds     

What is a puncture wound?

A puncture wound is when the skin has been completely punctured by an object that is pointed and narrow, such as a nail. The wound is not wide enough to need stitches.

Because puncture wounds usually seal over quickly, there is a greater chance of wound infection with this type of skin injury. Puncture wounds of the upper eyelid are especially dangerous and can lead to a brain abscess. A deep infection of the foot can begin with swelling of the top of the foot 1 to 2 weeks after the puncture. Another risk is tetanus if your child is not immunized against tetanus.
 

How can I take care of my child?

  • Cleansing. Soak the wound in warm water and soap for 15 minutes. Scrub the wound with a washcloth to remove any debris. If the wound rebleeds a little, that may help remove germs.

  • Trimming. Cut off any flaps of loose skin that cover the wound and interfere with drainage or removing debris. Use fine scissors after cleaning the scissors with rubbing alcohol.

  • Antibiotic ointment. Apply an antibiotic ointment and a Band-Aid to reduce the risk of infection. Resoak the area and reapply antibiotic ointment every 12 hours for 2 days.

  • Pain relief. Give acetaminophen (Tylenol) or ibuprofen (Advil) for any pain.
        

When should I call my child's health care provider?

Call IMMEDIATELY if:

  • Dirt in the wound remains after you have soaked the wound.

  • The tip of the object could have broken off in the wound.

  • The sharp object or place where the injury occurred was very dirty (for example, a barnyard).

  • The wound looks infected (redness, streaks, pus).
        

Call during office hours if:

  • It has been at least 5 years since your child last had a tetanus booster.

  • Pain, redness, or swelling increases after 48 hours.

  • You have other questions or concerns.
        
     

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Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
 
 
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